Varicose veins are a disease that affects around a third of the world's population, which is considerable. In this regard, the treatment of this pathology requires modern and effective solutions.
Medicine is developing, modern methods of treating varicose veins are appearing, which are less and less traumatic and invasive, which contributes to the rapid rehabilitation of the patient. Procedures of this type are carried out in clinics.
How were varicose veins treated in the past?
The problem of varicose veins accompanies humanity from the moment he (man) became erect. It is known that no species of other mammals suffer from this pathology, therefore humans have been fighting against it for a long time, for example:
- There is a cave painting found in the Sahara Desert that depicts people with bound feet. The painting is approximately 5, 000 years old.
- In medical manuscripts found in Egypt, it is indicated that it is not necessary to touch the enlarged veins under the skin, but many healers still experimented on the wives of the pharaohs - they cauterized the diseased veins.
- Central and South American Indians used medicinal herbs, including amaranth, to treat varicose veins.
- Information about this pathology can also be found in the works of the Greeks (Hippocrates, Herophilus and Erasistratus). What is remarkable is that the first of these doctors developed both conservative and surgical methods of treatment.
- The Roman scientist Celsus used special hooks to combat pathology (interestingly, the devices are still used today for modern treatment of varicose veins, in particular by miniphlebectomy).
- As for China, it was customary to combat diseased blood vessels using leeches, acupuncture and cauterization.
- In Japan, special attention has been paid to conservative treatment.
- It is not for nothing that the Middle Ages are called "dark", because in Europe there were a lot of prohibitions related to operations ("interference in the affairs of God"), and the affected veins, as a rule, were simply cauterized.
- At the same time, medicine was actively developing in the Middle East - for example, the famous doctor Avicenna tightly bandaged diseased vessels (which today are mainly used for prevention or rehabilitation).
- The Renaissance, the New Age, all this is a period of discoveries, including in medicine. Doctors are increasingly studying the principles of venous circulation. Scientists developed various surgical methods, some of which are still used today, and new methods of sterile vein ligation were created.
In the 20th century, the laser procedure began to be studied and new, more effective treatment methods were created. This process continues, without stopping for a single minute. Of course, the way varicose veins are treated today is very different from how it was in ancient times.
Modern methods of treating varicose veins
The newest methods of treating varicose veins are obliteration and coagulation of various types - these are the least traumatic manipulations. Let's take a closer look at some types of modern methods of combating varicose veins.
Endovenous laser coagulation
You can often find the abbreviated name of this method - EVLC. The principle of operation is as follows: a laser light guide, which heats the blood, is placed in the cavity of the diseased vein. As a result, the vessels are sealed, and for a while the vein turns into connective tissue. The process itself lasts 20-30 minutes, after which you may only need to wear special knitwear for 40-60 minutes. Further conservative and compressive treatment is determined by the doctor based on medical history. This procedure can be performed on both lower limbs.
The advantages of this modern method of treating varicose veins are:
- duration – only 20-30 minutes;
- the manipulation does not require cutting, applying or removing sutures, since the intervention is carried out by puncture;
- painless (performed under local anesthesia) and safety;
- rapid recovery (you can return to your normal life on the day of the procedure);
- minimal trauma, excellent aesthetic appearance after surgery.
However, the treatment method also has contraindications, including:
- obesity in the legs;
- blood clotting disorder;
- extreme stage of the disease, for example pronounced dilation of the vein, which may require surgery or combination therapy;
- severe atherosclerosis of the arteries of the lower limbs, which requires a special approach;
- intolerance to anesthetic drugs used in EVLT;
- period of pregnancy and breastfeeding;
- deep vein thrombosis in the acute phase;
- inflammation at the site of injury;
Additionally, EVLT is usually not prescribed if the patient is unable to actively move after manipulation or if they have a condition that makes it impossible to wear special stockings to avoid bruising or complications.
Radio frequency obliteration
Another modern type of non-surgical treatment for varicose veins is radiofrequency obliteration, or RFO. The treatment is carried out through the use of a radio frequency generator. So, sound waves penetrate through a special catheter with radiation, which heats and then narrows the walls of the vessel.
It should be noted that the vein is completely sealed: after the procedure, it is enough to treat the manipulation site with an antiseptic and apply a sterile dressing. The peculiarity of this method is that the procedure can be prescribed for heart and kidney diseases, and not only for varicose veins.
RFO has the following advantages:
- painless (local anesthesia is used during application), as well as safety;
- duration no more than 40 minutes;
- visible results after just 7 days;
- minimal trauma, excellent aesthetic appearance;
- complete "adhesion" of blood vessels;
- high efficiency;
- the possibility of using this method if the patient suffers from other diseases;
- no additional surgery is necessary.
There are also contraindications to the use of this procedure. Among them:
- inflammatory process at the site of injury;
- infectious and viral pathologies;
- pregnancy and breastfeeding;
- vein thrombosis;
- severe atherosclerosis of the arteries of the lower extremities - as already noted, this pathology requires surgical intervention;
- allergic reaction to the anesthetics that will be used during the procedure.
In addition, a contraindication is the case where the patient presents a pathology which prohibits them from wearing compression stockings.
Steam Obliteration
This method is one of the most recent in the history of medicine. So-called "steam injection" combines EVLT and RFO. It is the least invasive – compared to the others – and it is today considered the most versatile of all. As with the procedures described above, steam obliteration does not require additional hospitalization.
The most pleasant advantage of the method is the possibility of its use at any stage - very deep veins can be treated with this type of intervention. The fact is that the steam enters the vessels very quickly and without particular obstacles, filling the bends of the veins.
The principle of the method is as follows: water under pressure is pumped into a tube that is heated by an electric current, and thus the water changes its structure, turning into steam, which enters the container, where it isagain transformed into water, while the vascular walls absorb the heat generated by such simple manipulation.
Like the procedures described above, this manipulation also does not last long. The patient recovers quickly and after completing the process and wearing compression stockings for 30-40 minutes, he can return to his usual lifestyle.
Mechanochemical obliteration
It combines a mechanical effect on the walls of blood vessels and treatment of the patient with chemicals. After a small puncture, a special catheter is placed at the site of the lesion. With its help, a device is inserted that damages the walls of blood vessels, thereby sealing them. The manipulation is carried out on the internal surface of the vein and therefore does not require the use of anesthetics. At the end of the procedure, the puncture site is covered with a sterile bandage or napkin. Additionally, the patient must wear compression stockings for 30 to 40 minutes.
As obliteration does not require anesthesia, this method may be indicated if the patient is intolerant to anesthetics. It is also recommended for people with a low pain threshold. In addition, this procedure can also be performed if the patient has trophic ulcers.
Rapid rehabilitation, the ability to return to a normal lifestyle as soon as possible, minimal restrictions during the recovery period - these are the advantages of the above therapeutic method. The advantage of mechanochemical obliteration is the reduced risk of infection due to minimal trauma.
Adhesive cancellation
Another procedure that may be recommended for patients suffering from varicose veins is called adhesive obliteration. It is noteworthy that after the manipulation is completed, there is no need to wear special knitwear.
Like other methods described above, this method does not require incisions: a special glue is injected into the lumen of the diseased vessel, which seals the inner walls and redirects blood circulation through healthy veins.
This method of treatment can be prescribed to patients with a complication due to varicose veins (as a rule, it is clearly visible on the lower leg). The intervention is also carried out in patients with a large diameter of the affected veins (unlike the methods described above).
Which of the modern methods of treating varicose veins is the most effective?
All of the above methods for treating varicose veins are very effective, but each of them has its own characteristics, in which a specific procedure is recommended for a particular patient. If a person is contraindicated to wear compression stockings and/or if they have complications due to varicose veins, they will be prescribed an adhesive obliteration. If there is a possible allergic reaction to an anesthetic, a qualified specialist can prescribe mechanochemical obliteration.
Also, the criteria for choosing the most suitable varicose vein treatment method are as follows:
- Safety, absence of adverse reactions.
- Efficiency.
- Duration of saving the result.
The last point deserves to be mentioned separately, because this criterion is very revealing of one of the analyzes based on the results of 119 studies comparing RF, surgery, sclerotherapy and EVLT.
Therefore, these results (indicators in percentages) show that:
- 5 years after the intervention, the effectiveness of EVLT increases from 92. 9 to 95. 4. Compared to RFO, the effectiveness of this method decreases over 5 years from 88. 9 to 79. 9.
- As for the results of surgical intervention, the effectiveness of this method decreases from 80. 4 to 75. 7 over 5 years. In the latter case, over 5 years, you can also see a decrease in the effectiveness of sclerotherapy from 82. 1 to 73. 5. However, procedures such as, for example, surgery are usually prescribed in cases whereit is impossible to use more effective treatment methods. varicose veins.
From the study we can clearly conclude that today the most progressive and effective method for treating varicose veins is EVLT, because unlike the other methods with which the comparison was made, its effectiveness increases with thetime, and not the other way around, decreases. It should be noted that the clinics carry out all the procedures indicated in the article that can help the patient in the treatment of varicose veins.